Could a policy of provision of hip protectors to elderly nursing home residents result in cost savings in acute hip fracture care? The case of Ontario, Canada |
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| Authors: | A. M. Sawka A. Gafni P. Boulos K. Beattie A. Papaioannou A. Cranney D. A. Hanley J. D. Adachi A. Cheung E. A. Papadimitropoulos L. Thabane |
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| Affiliation: | (1) Division of Endocrinology and Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada;(2) Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada;(3) Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada;(4) Division of Rheumatology and Department of Medicine, St. Joseph’s Healthcare and McMaster University, Hamilton, ON, Canada;(5) Division of Geriatrics and Department of Medicine, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada;(6) Division of Rheumatology and Department of Medicine, University of Ottawa, Ottawa, ON, Canada;(7) Division of Endocrinology and Metabolism, Department of Medicine, University of Calgary, Calgary, Alberta, Canada;(8) Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada;(9) Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada;(10) Eli Lilly Canada, Toronto, ON, Canada;(11) Centre for Evaluation of Medicines, St. Joseph’s Healthcare, Hamilton, ON, Canada;(12) Toronto General Hospital, 200 Elizabeth Street, Eaton North 12-212, Toronto, ON, M5G 2C4, Canada |
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| Abstract: | Summary Hip fractures are an important problem in nursing homes. Hip protectors are external devices that decrease the risk of hip fracture in elderly nursing home residents. We estimated the overall healthcare cost savings from a hypothetical strategy of provision of hip protectors to elderly nursing home residents in Ontario, Canada. In a recent meta-analysis, we determined that a strategy of provision of hip protectors decreases the risk of hip fracture in nursing home residents. Introduction Our objective was to determine whether the provision of hip protectors to all Ontario nursing home residents aged ≥65 years could result in cost savings, stemming from reductions in initial hospitalizations for hip fracture. Methods We conducted a cost analysis from a Ministry of Health perspective (one year cycle length). The efficacy of the intervention was estimated from a meta-analysis of randomized controlled trials. Results A strategy of provision of hip protectors to all 60,775 elderly Ontario nursing home residents could result in an overall mean cost savings of 6.0 million Canadian dollars in one year (95% credibility interval, −26.4 million, 39.7 million), with a probability of cost savings of 0.63 (assuming no additional labor costs). In sensitivity analyses, decreasing hip protector price increased cost savings, whereas additional labor expenditures for application for hip protectors decreased cost savings. Conclusion In conclusion, if hip protectors can be provided to elderly Ontario nursing home residents without additional labor expenditures, there is a reasonable probability that such a strategy may result in healthcare cost savings. |
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| Keywords: | Cost Elderly Health economics Hip fracture Hip protector Osteoporosis |
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